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Hi all,
Diesel is 10 months old and was neutered today. We did elect to do the pre-neuter basic blood work just as a precaution. We decided on this as back in July he was sick for a few days with diarrhea and vomiting, and when we took him to the vet they did blood work which showed an elevated liver enzyme (unsure of which enzyme). At the time we were just told by our vet that it was likely he got into something and picked up an infection - antibiotics and anti diarrhea meds cleared it up really quickly. However, his pre-neuter blood work showed that the enzyme which was high in July is now within normal range BUT a different enzyme is now 3x higher than normal. He is not showing any symptoms and is perfectly healthy, acting normally and full of energy. The only somewhat odd thing that we've noticed is that if he doesn't have a handful of kibble before bed, he gets sick in the morning if his breakfast is later than usual (just with a bit of yellow bile). Given that he's not symptomatic our vet just wants to re-test in 2 months or so.. but I wanted some more opinions on here as well.
What could be causing this? Everything I've read says it can be a really nonspecific sign - but of course, being a first time golden owner, my mind jumps to the worst case scenario (eg he has cancer, death is imminent..all those nasty thoughts). Where do I go from here?
Thanks all.. much appreciated.
 

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Let me start by saying I am not an expert, nor am I a vet. I have, however, had dogs who showed high liver enzymes at times. Yes, one of them had cancer. HOWEVER she was 14 years old at the time. Another dog who demonstrated high liver enzymes was a rescue who arrived here in pretty bad shape. She was about a year old, had been treated for various intestinal parasites and chronic diarrhea in addition to multiple skin infections. When her bloodwork showed high liver enzymes (I am sorry it has been several years and I cannot specifically remember which enzymes were elevated) my vet suspected it was the result of the worming and multiple antibiotics as well as the infection she had been treated for. She had also recently given birth to a litter of puppies under less than ideal conditions. My vet prescribed milk thistle for her on a short term basis. Milk thistle was given to detoxify her liver. I have listed below a website about milk thistle. It is NOT something you should give unless it is done under veterinarian supervision. It is, however, worth asking about. The dog I just told you about is Gracie, the black dog in my signiture photo. She will be 12 years old soon. She is in excellent health and works as a therapy dog.The black and tan coonhound in the signature photo, Jack, has also showed high liver enzymes on 2 occassions. Jack is also a rescue who has had some serious issues with things which cause him stress. One of the things Jack will find stressful is a car ride to the vet. We discovered Jack's liver enzymes were perfectly normal when the blood draw was done by my neighbor (who is a vet) in my home but the ones done in the office were high. Stress can cause elevated liver enzymes. My point in this post is to tell you that there are many reasons for high liver enzymes. If your vet is not concerned at this point and advises re-testing in 2 months I would go with that. I know it is really difficult when you get a lab result that is off. Your first instinct is to Google it and then go online for more info. Usually it results in scaring the pants off of you. I know, I've done it. If you trust your vet, and I assume you do, take his/her advice and re-test. As for the vomiting bile...have you discussed feeding Diesel smaller meals more often? That will sometimes help.
Milk Thistle for Dogs | Safe Herbs for Dogs
 

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I think everything G-bear said is very sensible. Not knowing which enzymes are elevated, I really cannot comment any further on that, except to say that there is one which you expect to be elevated in growing puppies because it is not only released by the liver but also by bone. Although different enzymes are released from different parts of the liver (biliary vs hepatocytes, cell membrane vs interior of cell) so the specific enzyme can give you an idea of where there may be a problem, the problem is that, as you said, it is really non-specific. Elevated liver enzymes in a clinically normal patient are the bane of my existence as a vet because you never know how far to chase them. The usual start is to recheck in a couple of months to see if it was just a one-off.

As far as the vomiting goes, that sounds like a classic case of bilious vomiting syndrome (yes, it's a thing). Symptoms are vomiting bile if have gone a long time without eating (usually happens in morning as they don't eat overnight). Treatment? Usually exactly what you say -- give them some food before bed to reduce the time they have an empty stomach. However, in the face of the elevated liver value, it is good to make sure your vet knows about this, but it really sounds classic!
 
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